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Touchpoints Oct 1, 2006

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Array July 2006
UCJIPO I NTS
UBC
School of
Nursing
PUTTING    SCHOLARSHIP    INTO    PRACTICE
UBC
«
Contents
1 Preparing the Next Generation
2 Raising the Bar
One Stop Shopping for Health
3 Advances in Research
4 Development
A Passion for Public Health
5 Undergraduate Profile
Thinking Globally, Acting Locally
Three Generations
6 Graduate Profile
Sustaining Social Consciousness
7 Teaching Excellence
The Glorious Complexity of Aging
8 Clinical Teaching Innovation
Simulating Practice Reality
Save-A-Tree® eco audit
Touchpoints is printed on Save-a-Tree® 100%
post-consumer waste paper.
mk Trees Saved: 4
>*^i Wood Saved (Lbs.): 2,457
\1 Water Saved (gals.): 3,612
Uf Landfill Reduced (Lbs.): 383
j. Net Greenhouse Emissions Reduced (Lbs.): 743
H Energy Reduced (BTU) (000): 4,890
Preparing the Next Generation
Dr. Sally Thorne
It is well recognized that Canada faces a significant challenge as the current
generation of senior nurses retires over the coming decade. At the UBC
School of Nursing, our faculty members take such demographic factors
into serious consideration as they review our collective priorities and set our
organizational targets for the coming years. What we recognize is that the
UBC School of Nursing will play a particularly important role within the
province and the country by creating the conditions under which a wide
range of nursing programs can continue to prepare new nurses. Among the
key factors ensuring the continuation of nursing workforce renewal
over this period will be a sufficient supply of qualified nursing educators
to prepare that next generation of nurses and nurse leaders.
In the current context, nurse educators with
various types of educational preparation and
role definitions will be needed, and the School
is well positioned to play an increasingly
important role across that diversity. Clearly,
the system will require an army of clinical
educators—nurses who are proficient in clinical
practice and also competent in the complex
art of facilitating clinical learning. Our master's
program, which permits graduate students
to place a special focus on nursing educational
skill development, is constantly evolving
to meet this need. We have been offering a
specialized focus in nursing education to
graduate students both on the Lower Mainland
campus and in the Interior Health Authority
through our collaboration with Thompson
Rivers University (formerly University College
of the Cariboo) in Kamloops. We are also
working closely with our partners in Vancouver
Coastal and Fraser Health Regions to create
new and exciting initiatives in clinical education
within those health authorities. We see a
continued need for expansion of our capacity
to prepare highly skilled nurse educators at
the master's level,    continued on page 3 Raising the Bar
One Stop Shopping for Health
At this clinic you want people talking about you behind your back.
The UBC Health Clinic opened its doors this March to a new way of
health care. "We're excited to launch one of the first models of interprofessional health care education in the province," says Dr. Christie
Newton, Assistant Professor of Family Practice and Clinic Director.
The clinic was developed in collaboration with
program leaders in medicine, nursing,
midwifery, family nurse practice, rehabilitation
sciences, pharmacy, counselling and a
range of other partners. "The James Mather
Clinic started in the 1960s as a training
ground for medical residents," says Gloria
Joachim, Associate Professor and Program
Coordinator for the Family Nurse Practitioner
Program in the School of Nursing. "The
committee for the UBC Health Clinic had the
vision of expanding the original clinic
to include not only family practice but other
health disciplines as well. We are creating
an environment in which various disciplines
can communicate with and learn from each
other, together."
Patients of the UBC Health Clinic have access
to a variety of primary health care providers.
There are 15 practicing faculty members and
over 45 health care providers-in-training.
Consultation is available from pharmacists, a
behavioural medicine practitioner, and family
physicians, while primary care is offered by
family practice residents, a family nurse
practitioner, midwives and others. Greeted by
a receptionist well-versed in the roles
and skills of the various disciplines, patients
are matched with the appropriate specialist
for the particular concern. "If any of the
specialists who see the patient are unsure,
they can consult with the supervising
physician or other specialists in the clinic
to help reach the correct diagnosis,"
says Gloria. "This primary care clinic is the
storefront of health care."
As a new initiative in professional practice
education, the UBC Health Clinic offers
many opportunities for trained and training
professionals from a variety of disciplines to
learn about, with and from each other. "The
person who knows the most about a particular
subject is the one who takes the lead,"
says Gloria. "We are continually learning what
each other does and what our strengths are,
and we collaborate from the ground up." Each
Wednesday a different health professional
makes a presentation. Presenters have
included residents, nurse practitioners and
faculty members from the School of Nursing.
It is well-known that British Columbians need
increased access to health care and nurse
practitioners can help meet that need. "Nurse
practitioners put a great emphasis on health
teaching and health promotion," says Gloria.
They have legislated authority enabling them
to independently diagnose and treat diseases
and to prescribe medication.
"The opening of this clinic means a lot to me
because it shows that nurse practitioner
practice is valued," says Gloria. "We're on the
cutting edge here because we are privy
to the pressing issues and needs of people.
Because of our primary access to patients,
we are able to anticipate the future concerns
of clients and share that information
with our respective faculty members in the
academic setting."
Currently, faculty and students in this clinic
work, learn and teach in a participatory model
and there is much room to grow. The clinic
is keen to have more family nurse practitioner
students, and to use this as an opportunity
to role model the family nurse practitioner role
in its full scope of practice.
The UBC Health Clinic is accepting new
patients. If you would like to be treated by
an entire team of providers contact
604-822-5431. You may also visit the website
for the Faculty of Family Medicine at
www.familymed.ubc.ca. Advances in Research
Dr. Susan Dahinten, Assistant Professor, is an example of one of the
School of Nursing's exciting new researchers. Her passion is early childhood
development, and she believes that the health of a society is linked to
the quality of attention and care paid to its youngest members. "The aim
of my research is to contribute to a better understanding of the social
determinants and processes of child development, and to enhance public
health efforts at identification, intervention and the prevention of
developmental problems," says Susan.
While nurses have always played a leading
role in individual care and early detection
of health problems, Susan believes that it is
timely for nurses to engage with other
child development specialists in a population-
focussed approach to fostering the health
and development of young children. "Nurses
are in an ideal position to assess and
monitor young children's development, to assist
families to support the healthy development
of their children and to ensure that families are
connected with appropriate services,"
she says.
A graduate of UBC Nursing's doctoral program,
Susan held a faculty position at the University
of New Brunswick for three years before
returning to the School as a faculty member.
Since her arrival, Susan has developed a
program of research involving multidisciplinary
and multi-site teams. "There are strong
and well established relationships between
education and health. School readiness (a
child's ability to take advantage of learning
opportunities in school) is currently
understood to encompass physical well being,
motor development, emotional health and
social competence, in addition to language
skills, general knowledge and cognitive skills."
As a testament to the importance of the role
she plays in developing new statistical
techniques for doing this complex population-
based research toward improving the health
status of children, Susan has recently become
one of the School's newest recipients of
the prestigious Michael Smith Foundation for
Health Research Career Investigator Awards.
This award will provide substantial support
for a six year period so that she can maximize
the development of this body of knowledge
development as part of the MSFHR funded
Child and Youth Developmental Trajectories
Research Unit. She will also guide a new
generation of graduate students in learning
the complexities that this kind of research
entails. The School is proud of its capacity to
support the incredible contributions that
scientists like Susan make to knowledge that
can truly help protect the health of young
children and other vulnerable populations.
Preparing the Next Generation
  Continued from page 1
In addition, the School of Nursing remains
one of the country's leading sites for doctoral
education in nursing. The doctoral program
builds upon the advanced skill sets with which
its students enter and provides them with
a comprehensive understanding of nursing
science and the capacity to develop and
lead an outstanding program of scholarship
within the discipline. Doctorally prepared
nurse educators will be the core of the academic development of nursing throughout
the system, contributing the academic leadership required to ensure a wide base of
strong nursing educational offerings across
the province and the country.
Working together, these various kinds of
nurse educators will be the foundation upon
which we build the nursing "safety net"
for our future. The School of Nursing is proud
to remain at the forefront of anticipating
the needs of the population, analyzing the
challenges in all of their complexity, and
identifying its unique leadership role in solving
problems. In the current context, we see
a strong focus on the scholarship of nursing
education as among our highest priorities.
Inez Jasper (BSN '06), a nursing leader of the
future, honoured her First Nations heritage
during her convocation address to the graduating
class on May 30, 2006. Development
A Passion for Public Health
Monica Green, RN, MPH, (1917-2004) was a dedicated health care
professional who helped create one of the first post-hospital home-care
programs in Canada while she was Director of the Provincial Public
Health Nursing Service. She was also President of the Canadian
Public Health Association (CPHA), was made a Fellow of the American
Public Health Association and received an Award of Merit from the
BC branch of the CPHA for her contributions to public health services
and public health nursing.
Monica Mary Green (nee Frith) passed
away in Victoria on December 28, 2004.
"An outstanding contribution that came about
under Monica's direction was the introduction
of research studies to help clarify the results
of public health nursing activities," says
Glennis Zilm, Honourary Professor, UBC School
of Nursing. "It was no longer possible
to measure results of public health nursing
simply through reporting the statistics
on communicable disease, and public health
work had become a team affair, including
more physicians and social workers,
school counselors, and psychiatrists. So the
department instituted a series of small
studies to measure the effectiveness of
nursing visits." The results of these
studies, included in Monica's book, Through
the Years with Public Health Nursing,
published in 1984, showed that the public
health nurses had met their objectives
and that their work was effective.
Among her many legacies, Monica's book is
one of the best documented histories of
public health nursing in Canada. Another of
her legacies is the Monica Mary Green Fund
that she left as a bequest to the School.
This fund will provide support to develop new
research initiatives by UBC nursing graduate
students and junior faculty members in public
health in any of its forms including screening,
early intervention, ease surveillance, health
promotion, disease prevention, fostering
self care and community empowerment.
The inaugural Monica Mary Green Fund
research award will go to MSN student
Lyle Grant for his qualitative study of what
influences smoking behaviour among
community-dwelling persons with severe
and persistent mental illness.
Now You Can
Donate Online
Please help ensure high quality education
for the next generation of UBC nursing
students by making a gift to the UBC School
of Nursing. Whether you're interested
in clinical instruction, research, student
support or international nursing
initiatives, the School needs your support.
For your convenience, it is now possible
to get more information and to donate
online at www.nursing.ubc.ca. You will
find details about areas where financial
support is needed. Click on the DONATE
button to get to the donation page.
If you are thinking of making a special
gift to the School such as an endowed
professorship, student scholarship
or bursary, or the purchase of equipment,
please call Celeste Taylor at
(604) 822-9959. She would be pleased to
provide information about donating
cash, securities, property or about other
important ways you can help the UBC
School of Nursing.
To find out more, or to have a confidential
discussion about making an estate gift
to the School, please call Cheryl Stevens
at 604-822-1232. Undergraduate Profile
Thinking Globally,
Acting Locally
Before we reach the nursing station
where the interview will take place,
Nashreen Dhalla, BSN '06, has
been stopped and warmly greeted
by three clients of the day health
program at the Dr. Peter Centre.
With each, she offers undivided
attention, a smile and some kind
of human touch.
Some of these faces are familiar to Nash,
who spent nine years working in the Downtown
Eastside as a TB outreach worker before
returning to UBC to obtain her baccalaureate
degree in nursing. "I had reached the cusp
of what I could achieve," says Nash, "so it was
a logical progression to apply to the advanced
standing program at UBC. The program would
offer me the skills needed to better serve the
community in the DTES."
With an undergraduate degree in international
development from the School for International
Training in Brattleboro, Vermont, Nash traveled
to and worked in Zimbabwe and India. Her
experiences created a keen awareness of the
broader health issues and have enhanced
her passion to think globally but work locally.
"I'm Canadian, I live in Vancouver and there
are communities right here that need help.
We need to take care of our fellow citizens."
Because Vancouver is home to such an
industrialized society, Nash knows that many
in the city do not "see" people below
the poverty line, and couldn't imagine that
tuberculosis, for example, is still an issue
today, or that some people deal with the
dual diagnosis of mental health issues and
addictions. "If we take care of our most
marginalized in society, then I believe the
rest of society gets taken care of as well,"
says Nash. "By supplying help to the lowest
common denominator it helps everyone."
During an elective clinical course toward the
end of her BSN program, Nash had the
opportunity to travel to South Africa and work
with communities that have a high incidence
of HIV/AIDS. Had it not been for fundraising
and financial support, Nash, along with fellow
student Sarah Rhode, would not have been
able to take advantage of this incredible learning opportunity. "It broadened my scope
and recharged my batteries to come back to
Canada and do the work needed here."
Currently, Nash works in three areas. Her
role in the Day Health Program at the
Dr. Peter Centre comprises pain consultation,
medication support, harm reduction services,
and health education for people with HIV/AIDS
and addictions. She also works part time as
a community health nurse with the Vancouver
Coastal Health Pender Clinic, and on the
IOC HIV ward at St. Paul's. "As a new nurse
I need to have hospital experience to solidify
my skills," says Nash. "I'm focusing on
TB and HIV/AIDS—that's my passion—but I
need to be aware of the in-hospital side of
nursing too."
Nash says the BSN program at UBC has given
her the tools to effect positive change in the
communities she works with. "I wouldn't have
thought of being able to change policy before
coming to UBC," she says. "I didn't even think
I'd be going back to school and now I'm
thinking of doing a master's in public health!"
For members of the communities in which
Nash works, this is welcome news indeed!
For the School, Nash offers an outstanding
example of new graduates taking their
scholarship and putting it directly into practice.
Three Generations
May 30, 2006 marked the graduation of the
third generation of nurses in Sarah Williams'
family. Her grandmother, Violet Porter (UBC
Public Health Nursing Diploma, '38), worked
in the burn unit and surgical unit at Vancouver
General Hospital before becoming the
first public health nurse in Nanaimo, BC. "She
worked prior to the introduction of antibiotics
and was instrumental in moving nursing
forward in terms of being recognized as
an autonomous, respectable profession,"
says Sarah.
Sarah's mother, Anne Williams (BSN '65),
worked as a public health nurse for 35 years
in Vancouver and on the Island. Anne
won the Sterling Award for her service to the
Nanaimo community in her position
as Director of Central Vancouver Island
Community Services for Infants, Children,
Youth and Family.
"My mother and grandmother are true
advocates for families in the community and
believe everyone has a right to the determinants of health," says Sarah. "I feel confident
moving into the family nurse practitioner
role because nursing is in my genes. I know
that both my grandmother and mother
were pioneers in their nursing careers, and
that I can always look to them for advice
and support." Graduate Profile
Sustaining Social Consciousness
Darlene Pankratz, MSN '06
A full-time sessional faculty member at Trinity Western University,
Darlane teaches senior nursing undergraduates to find and share creative
ways of communicating and working with patients. "My enthusiasm
around creativity in the classroom stems from the fact that we have
different types of learners," she says. "We need to use different learning
strategies to accommodate all students. Creativity expands the students'
ability to see new ways to intervene in health care, and their own personal
use of creativity helps them cope with the stressful demands of nursing."
One such strategy is the annual practicum in
which some of Darlane's students participate.
As part of their community health course,
some students have the opportunity to go to
rural areas of Guatemala to share health
promotion strategies in elementary schools
and health fairs. "During my career I've seen
examples of marginalized care in our health
care system for people who may have a
different ethnicity, world view or culture, and
for people who may speak a different
language," says Darlane. "When students are
placed in an international setting they
become the minority and receive a first hand
learning experience in that role."
As part of the final scholarly project to
complete her master's degree, Darlane
became interested in learning more about
the dynamics of international learning
experiences within nursing education.
With principal-investigator Dr. Sheryl Reimer-
Kirkham, she has now embarked on a
new project to examine what it is that causes
learning within an international setting and
what causes a student to sustain that social
consciousness once home.
"These students go through a transformational
experience," she says, "and without any
intervention once they're home, the transformation tends to fade. Everything comes
at them and they need some time once they're
home to process what they've been through,
read through their journals and reflect on the
experience. Our research is considering
what may influence sustaining the transformation and promoting involvement in social
justice issues here."
Returning to school to obtain her master's
degree in nursing opened Darlane up to a
new world of nursing and health care
research. While an emergency room RN at the
UBC Hospital, Darlane had found herself
drawn to research articles but felt frustrated
that she couldn't completely grasp the
language of research and understand how and
when to apply the findings. "There's so
much out there to find out about," she
observed. "I began to understand just how
close nurses were to the front line and
how much of an opportunity we have to make
changes to policy."
During her time at UBC, Darlane received
the Hamber Scholarship in Nursing and the
Grace Torchy Stewart Adamson Memorial
Scholarship. As she recalls, the support of
such scholarships made a significant
difference in her ability to accomplish her
goals. "These awards came at a tremendous
time of need for my family, and they gave
me encouragement to continue." With two
children in a close-knit family, Darlane
felt the pressure associated with taking time
away from her children to devote to
her studies. However, as the smiles on her
children's faces at graduation proved,
there is no doubt they are proud of their
mother's decision! The School of
Nursing is inspired by the accomplishments
of its graduates as they apply their
newfound scholarly and professional skills
to new strategies with which to strengthen
the profession. Teaching Excellence
The Glorious Complexity
of Aging
Within the first five minutes of class,
Dr. JoAnn Perry, Associate Professor, polls
her "Nursing Care of Older Adults" class
for examples from their own lives related to
the day's subject of dementia. She acknowledges each response and incorporates
what the students offer into her lecture. This
level of engagement helps her students
relate the material to their own lives and experiences and, in so doing, expands their views
of older adults and their care. "I know our
students have the capacity to make changes,"
says JoAnn, "and if care will improve for
our elderly it will be because we have a critical
mass of nurses who are well educated about
older adults and able to make change based
on knowledge, not myth."
This earnest enthusiasm for expanding the
knowledge base and practice passion of
her students contributed to JoAnn receiving the
2006 UBC Killam Teaching Prize—an honour
awarded to UBC faculty members who have
been nominated by students, colleagues and
alumni/ae. "I am truly honoured by this,"
says JoAnn, "in part because I see nursing as
a practice profession so when we teach
we have to be able to make the whole idea
of practice visible in the classroom in a
meaningful way."
JoAnn's passion for the field of gerontology
grew during her early teaching days when
she discovered the clash between clinical and
theoretical realities as they affected this
critically important population. "For many years
I had a joint appointment with the School
and the Vancouver General Hospital," says
With Warm Memories (1940-2006)
Members of the School of Nursing were
saddened by the recent death of friend and
colleague, Janet Gormick, RN, BSc, MSN,
April 27, 2006, after a brief struggle with
adrenal carcinoma. Janet began her
26-year career with UBC in 1971. During her
time at the School, she was involved with
JoAnn. "My office was in Purdy Pavilion (an
extended care facility on campus) so I got
to know the patients, staff, residents and
families very well." This intimate connection
allowed JoAnn to share practical knowledge
and theory between the classroom and the
clinical setting. She discovered that what was
being reported in the literature on dementia
in older adults didn't match exactly with what
was happening in the clinical setting.
The caregiver literature seemed predominantly
directed toward caregiver burden. "Without
a doubt there is burden," says JoAnn, "but the
experience is also filled with commitment,
family and cultural values, and pure and simple
love and devotion." As she began studying
the role of care giver she began to see
the unique relationship that exists between
the ill family member and the one giving
care. "This person is more than a caregiver,"
says JoAnn. "This person is also a daughter
or a wife or a brother."
As people age they become more and more
complex—a truth JoAnn tries to impart to her
students. "I love aging!" says JoAnn, "and
we really have to refine the notion of nursing
as collaboration with the elderly. This has to
come through what we teach nurses today.
Ten babies will more often than not be much
more alike than 10 older adults. There is
so much to learn and to know about communicating with and giving care to older adults."
Throughout her years of teaching, JoAnn
has developed a number of techniques to
engage students in the subject matter. "I
expect myself to be organized, prepared and
to approach each subject with an open
mind," she says, "and, I expect that from the
students as well. I want them to be open
to hearing what is being said so they can truly
think about it, accept it or challenge it."
the development of a UBC model for nursing,
theory development and curriculum building
as well as clinical practice in psychiatry,
and community and family health at both the
undergraduate and graduate levels.
Janet leaves behind a number of family
members and loved ones.
JoAnn's goal is to balance theory and practice,
to bring research into the classroom and
to bring theory into the practice. "Each week I
set a clinical goal in the class." The clinical
instructors and students take that goal, based
on the weekly lecture, into their clinical
placement. "During the next class we can talk
about how the theory played out in operation.
The integration is really important." JoAnn
hopes her students learn how to expand their
own repertoire of skills to communicate with
people who have dementia in order to make
their lives richer.
"If we could, as a society, be more embracing
of aging than thinking of it as dysfunctional
and sick then there wouldn't be such a strong
desire to deny it," she says. "Let's look at
the knowledge and wisdom that comes with
aging and not be afraid."
The School wholeheartedly congratulates
JoAnn on her 2006 Killam Teaching Prize and
looks forward to a future of nurses highly-
skilled in the realm of gerontology and caring
for the older adult. Clinical Teaching Innovation
Simulating Practice Reality
The School has recently purchased two high
fidelity patient simulators (Laerdal SimMan).
Simulation is the attempt to represent certain
key features of the behaviour of physical or
abstract systems by modeling this behaviour
in a simpler system. In the case of clinical
simulation these computerized "patients"
breathe, have pulses and are connected to a
monitor that shows their vital signs and their
responses to certain stimuli. The "SimMan"
can be programmed with a number of
conditions, disease states and symptoms,
and can respond to and generate verbal
and physical cues. This year the mannequins
will be used for evaluation and research
with a small group of senior students, and
midwifery and nurse practitioner students.
"What we hope for are funds to build an entire
Advanced Simulation Lab," says Dr. Bernie
Garrett, Assistant Professor, to be able to use
the technology with a number of different
groups. For example, undergraduate students
could use a SimMan in pre-registration training,
or interprofessional groups of medical,
pharmacy and nursing students could work
together on one SimMan scenario. "This
could help develop teamwork," says Bernie,
"and educate other students as to what
nurses can do and vice versa. Once nursing
students are in practice they work in
a multidisciplinary team, they do not work
in isolation."
The intention is to have simulation labs complement rather than replace clinical experience.
There are advantages to both controlled and
unpredictable learning environments. "Some
things are impossible to simulate, but we can
make students better prepared for practice,"
says Bernie. In a Simulation Lab, instructors
can program pre-controlled simulations
into the mannequin with known underlying
factors. This creates standardized
sequences of events; therefore, students
can all experience the same thing and
learn the same specific set of skills, whilst
building confidence.
Simulation can be used to help prepare
students more effectively for the challenges
of clinical practice. "With real-life patients,
students are exposed to highly complex
physical and psycho-social issues," says
Bernie. "Each patient is individual and can
have many unexpected factors coming into
play." The clinical environment also presents
any number of unexpected events. "It is
a complex environment with numerous
things going on concurrently, and students
need to learn this and acquire the ability
to decide on a set of actions in this
environment. Simulation can help prepare
them to do this, but cannot replace it."
Through instructor-facilitated sessions in
the Simulation Lab, students are able
to work through acute episodes they may
not have had a chance to experience
during their clinical experience; for example,
anaphylactic shock or a pneumothorax.
Instructors can also videotape the students
practicing and go over the tape with them,
highlighting excellent work and areas that
need improvement. "Simulation should
not replace practice experience," says
Bernie, "but it can make students better
prepared for practice, and enable them
to experience conditions they would otherwise not see."
Over the coming years, the School dreams
of expanding from the current two mannequins
to a full Simulation unit of 15 beds, and
continues to explore the possibilities for ensuring optimal assessment and psychomotor
skill development within the simulated setting.
In the current challenging health care context,
it will be increasingly important to ensure
that we provide a wide range of learning
opportunities so that all of our students can
be as practice-prepared as possible.
To uchpoiNTS
Touchpoints is published by the School
of Nursing, Faculty of Applied Science,
The University of British Columbia.
Editor: Sally Thorne
Associate Editor/Writer: Julie Lees
Editorial Advice: Dr. Marilyn Willman
Design/Production: Tandem Design Associates Ltd
Printing: Rhino Print Solutions
The UBC School of Nursing
T201-2211 Wesbrook Mall
Vancouver, B.C.  V6T2B5
PUBLICATIONS MAIL AGREEMENT NO. 40681575
RETURN UNDELIVERABLE CANADIAN ADDRESSES TC
THE UBC SCHOOL OF NURSING
T201-2211 WESBROOK MALL
VANCOUVER, BC  V6T 2B5
EMAIL: INFORMATION@NURSING.UBC.CA

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